A prescription for an antibiotic can feel reassuring when a patient has a fever, sore throat, cough or a lingering cold. However, the presence of infection-like symptoms does not automatically mean a bacterial infection is present. This distinction is central to safe treatment. Antibiotics target bacteria, not viruses, which are responsible for most uncomplicated colds, influenza and many cases of acute bronchitis.

The problem is that antibiotics are sometimes used as a precaution, particularly when symptoms persist for several days. This approach may appear harmless, but it exposes the patient to a medicine without a corresponding benefit. The latest WHO data show that one in six laboratory-confirmed bacterial infections causing common infections worldwide was resistant to antibiotic treatment in 2023. Resistance is not simply a hospital problem. Every unnecessary antibiotic course creates selective pressure that allows susceptible bacteria to be eliminated while resistant organisms survive and multiply.

There is also an immediate cost to the individual

The use of antibiotics can lead to side effects such as nausea, diarrhea, rashes, drug interactions, and allergic reactions. Additionally, damage to the gut microbiome, the unique collection of microorganisms involved in digestion and immune function occurs. Disruption of the body's natural balance could give rise to opportunistic infections such as Clostridioides difficile and result in severe diarrhea and colitis.

A great many people also make the mistake of believing that coloured mucus is a sign of bacterial infection. In reality, the appearance of yellow or green nasal discharge is solely a part of the body's normal reaction to illness. The same goes for persistence of cough after a cold, which does not indicate the onset of bacterial infection.

This doesn't imply that antibiotics must be completely avoided. Antibiotics are necessary whenever there is suspicion or confirmation of a bacterial disease. For example, antibiotic drugs may be necessary in bacterial pneumonia, streptococcal sore throat, some urinary tract infections, and certain complicated skin infections. The main principle here is diagnostic discrimination instead of baseless refusals.

Good treatment entails good diagnosis

Is there sufficient evidence confirming the presence of a bacterial infection? Is it possible that the identified condition turns out to be non-infectious? Is there any information providing a direct indication of pneumonia, sepsis, or some other complication? Where necessary, microbiological testing and antimicrobial susceptibility testing can make it possible to identify the causative agent and determine which medication can be used. The ICMR guidelines stress the importance of making an accurate clinical diagnosis and limiting the use of empirical antibiotic therapy in cases where it is really required.

Patients also have an important role

Do not use previously prescribed antibiotics by yourself, as well as do not take someone else's medications or stop taking treatment depending on the symptom. Proper use of antibiotics means adhering to the advice of the healthcare specialists. If antibiotics are considered unnecessary, the best option is to alleviate symptoms, be hydrated, have enough rest, and keep monitoring your health.

Therefore, the idea of antimicrobial stewardship is not that of treatment denial but of finding the best treatment, correct dosages, and proper duration of treatment. Under the increasing level of resistance and while antibiotics become scarcer, conservation of the current ones is extremely important for treatment effectiveness.

Being down with a cold can be inconvenient; however, using an antibiotic to treat a viral infection will not be effective at speeding up the process of recovery. In fact, it can bring about side effects and lead to a situation when normal bacterial infections can no longer be easily treated. The proper use of antibiotics starts with asking the question: Is the medication necessary? This practice not only safeguards the patients in the present but also secures a possibility to use antibiotics in the future.

(By Dr Chirag Tandon, Director, Internal Medicine, ShardaCare-HealthCity)



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